Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 0101226974 | VA |
Y | 207RP1001X | Pulmonary Disease | 0101226974 | VA |
NPI | 1063414399 |
---|---|
Provider Name | Dr. Jane J Wu |
First Address | Fairfax, VA 22033-1715 |
Second Address | Fairfax, VA 22033-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 26/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5845025 | (05) | VA |
G78558 | (02) |